Effect Of Body Mass Index Change Research Articles

The effect of body mass index reduction on intraocular pressure in a large prospective cohort of apparently healthy individuals in Israel.

To investigate the effect of change in body mass index (BMI) on intraocular pressure (IOP) in a large cohort of apparently healthy volunteers who underwent an annual comprehensive screening examinations. This study included individuals who were enrolled in the Tel Aviv Medical Center Inflammation Survey (TAMCIS) and had IOP and BMI measurements at their baseline and follow up visits. Relationships between BMI and IOP and the effect of change in BMI on IOP were investigated. A total of 7,782 individuals had at least one IOP measurement at their baseline visit, and 2,985 individuals had ≥2 visits recorded. The mean (SD) IOP (right eye) was 14.6 (2.5) mm Hg and mean (SD) BMI was 26.4 (4.1) kg/m2. IOP positively correlated with BMI levels (r = 0.16, p<0.0001). For individuals with morbid obesity (BMI≥35 kg/m2) and ≥2 visits, a change in BMI between the baseline and first follow-up visits correlated positively with a change in the IOP (r = 0.23, p = 0.029). Subgroup analysis of subjects who had a reduction of at least 2 BMI units showed a stronger positive correlation between change in BMI and change in IOP (r = 0.29, p<0.0001). For this subgroup, a reduction of 2.86 kg/m2 of BMI was associated with a reduction of 1 mm Hg in IOP. BMI loss correlated with reduction in IOP, and this correlation was more pronounced among morbidly obese individuals.

Effect of BMI change on recurrence risk in patients with endometrial cancer

ObjectiveOur study aimed to explore the effect of body mass index (BMI) change on cancer recurrence risk during the routine surveillance of endometrial cancer patients.MethodsData on patients with endometrial adenocarcinoma...

Protective effect of obesity on survival in cancers treated with immunotherapy vanishes when controlling for type of cancer, weight loss and reduced skeletal muscle

IntroductionAssociation of high body mass index (BMI) with longer survival has been reported in patients on immune checkpoint inhibitors (ICIs), but results are inconsistent. This ‘obesity paradox’ is potentially confounded by the effects of BMI change over time and of skeletal muscle depletion. MethodsWe conducted a secondary analysis of a prospective cohort, including consecutive patients receiving ICI treatment for melanoma (n = 411) and non-small cell lung cancer (NSCLC) (n = 389) in routine care. ResultsIn the univariable analysis of the entire population, overweight/obesity (BMI ≥ 25 kg/m2) was associated with longer survival (p < 0.01); however, this effect was limited to NSCLC (p < 0.01) and was absent in melanoma. Weight loss (WL) and reduced skeletal muscle mass were observed in patients within all BMI categories. WL was associated with shorter survival in multivariable analysis in both tumour sites (p < 0.01), and for NSCLC, BMI lost significance when WL was included (p = 0.13). In models further adjusted for CT-defined skeletal muscle mass, WL retained significance for both tumour types (p < 0.01), and reduced skeletal muscle only for NSCLC (p = 0.02) was associated with shorter survival. WL retained significance when biomarkers (lactate dehydrogenase enzyme, albumin and derived neutrophil to lymphocyte ratio) were added to the multivariable model. ConclusionsThe so-called ‘obesity paradox’, counterintuitive association between high BMI and longer survival, vanished when controlling for confounders, such as type of cancer, and manifestations of depletion (WL and reduced skeletal muscle mass).

Does interpregnancy BMI change affect the risk of complications in the second pregnancy? Analysis of pooled data from Aberdeen, Finland and Malta

ObjectiveWeight management interventions during pregnancy have had limited success in reducing the risk of pregnancy complications. Focus has now shifted to pre-pregnancy counselling to optimise body weight before subsequent conception. We aimed to assess the effect of interpregnancy body mass index (BMI) change on the risk of perinatal complications in the second pregnancy.MethodsA cohort study was performed using pooled maternity data from Aberdeen, Finland and Malta. Women with a BMI change of ±2 kg/m2 between their first and second pregnancies were compared with those who were BMI stable (remained within ±2 kg/m2). Outcomes assessed included pre-eclampsia (PE), intrauterine growth restriction (IUGR), preterm birth, birth weight, and stillbirth in the second pregnancy. We also assessed the effect of unit change in BMI for PE and IUGR. Logistic regression was used to calculate odds ratios with 95% confidence intervals.ResultsAn increase of ≥2 kg/m2 between the first two pregnancies increased the risk of PE (1.66 (1.49–1.86)) and high birthweight (>4000 g) (1.06 (1.03–1.10)). A reduction of ≥2 kg/m2 increased the chance of IUGR (1.15 (1.01–1.31)) and preterm birth (1.14 (1.01–1.30)), while reducing the risk of instrumental delivery (0.75 (0.68–0.85)) and high birthweight (0.93 (0.87–0.98)). Reducing BMI did not significantly decrease PE risk in women with obesity or those with previous PE. A history of PE or IUGR in the first pregnancy was the strongest predictor of recurrence independent of interpregnancy BMI change (5.75 (5.30–6.24) and (7.44 (6.71–8.25), respectively).ConclusionChanges in interpregnancy BMI have a modest impact on the risk of high birthweight, PE and IUGR in contrasting directions. However, a prior history of PE and IUGR is the dominant predictor of recurrence at second pregnancy.

A large-scale genome-wide association analysis of lung function in the Chinese population identifies novel loci and highlights shared genetic aetiology with obesity.

BackgroundLung function is a heritable complex phenotype with obesity being one of its important risk factors. However, knowledge of their shared genetic basis is limited. Most genome-wide association studies (GWASs) for lung function have been based on European populations, limiting the generalisability across populations. Large-scale lung function GWASs in other populations are lacking.MethodsWe included 100 285 subjects from the China Kadoorie Biobank (CKB). To identify novel loci for lung function, single-trait GWAS analyses were performed on forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in the CKB. We then performed genome-wide cross-trait analysis between lung function and obesity traits (body mass index (BMI), BMI-adjusted waist-to-hip ratio and BMI-adjusted waist circumference) to investigate the shared genetic effects in the CKB. Finally, polygenic risk scores (PRSs) of lung function were developed in the CKB and their interaction with BMI's association on lung function were examined. We also conducted cross-trait analysis in parallel with the CKB using up to 457 756 subjects from the UK Biobank (UKB) for replication and investigation of ancestry-specific effects.ResultsWe identified nine genome-wide significant novel loci for FEV1, six for FVC and three for FEV1/FVC in the CKB. FEV1 and FVC showed significant negative genetic correlation with obesity traits in both the CKB and UKB. Genetic loci shared between lung function and obesity traits highlighted important biological pathways, including cell proliferation, embryo, skeletal and tissue development, and regulation of gene expression. Mendelian randomisation analysis suggested significant negative causal effects of BMI on FEV1 and on FVC in both the CKB and UKB. Lung function PRSs significantly modified the effect of change in BMI on change in lung function during an average follow-up of 8 years.ConclusionThis large-scale GWAS of lung function identified novel loci and shared genetic aetiology between lung function and obesity. Change in BMI might affect change in lung function differently according to a subject's polygenic background. These findings may open new avenues for the development of molecular-targeted therapies for obesity and lung function improvement.

Trends in bone mineral density among nutritional status categories of Vojvodina elderly population

Introduction/Objective. Low bone mineral density (BMD) is commonly associated with alterations of nutritional status. The aims of the present study were to evaluate the prevalence of low BMD and its associated nutritional risk factors in Vojvodina population and to use linear regression equations to predict the BMD by using a simple marker of nutritional status, body mass index (BMI). Methods. In this retrospective, cross-sectional study, the study population included subjects who were undergoing assessment of BMD between January and December 2017, and who have met the study inclusion criteria. A total of 1974 patients (1866 women and 108 men) were included in this analysis of nutritional status according to anthropometry and BMI index, and dual-energy X-ray absorptiometry (DEXA) measurements of BMD of the femoral neck and lumbar spine. The relationship between BMI and BMD was analyzed by linear regression equation. Results. Median age was 63 (56?70) years. Considering nutritional status category, there were 40% overweight, 31% obese and 29% normal weight subjects. In most of the sample, the subjects had low BMD, 37% had osteopenia, and 25% had osteoporosis. In both bone areas we observed trends of lowering BMD as the subjects BMI decreased. Subjects with osteoporosis are more prone to BMI depended BMD changes, concerning subjects with osteopenia and normal BMD. In addition, normal weight subjects compared to overweight and obese had the highest prediction coefficients of BMI-depended changes on BMD. Conclusion. High prevalence of low BMD coexists with overweight and obese elderly females in Vojvodina. Prediction equations for the calculation of BMD can be used to evaluate the effect of BMI changes on BMD in clinical settings.

Relation of Change of Body Mass Index to Long-Term Mortality After Cardiac Catheterization

Body-mass index (BMI) is a risk marker and therapeutic target in cardiovascular prevention. The effect of changes in BMI on mortality in patients with cardiovascular diseases has not been completely delineated. We aimed to assess the association between percent change in BMI, as measured 3-years after cardiac catheterization, and long-term mortality. Patients who underwent cardiac catheterization (n = 11,220; mean age 63 ± 10 years) were categorized according to BMI groups (normal-weight, 18.50 to 24.99 kg/m2; overweight, 25.00 to 29.99 kg/m2; obesity, ≥30 kg/m2). Follow-up BMI was considered the level measured closest to the timepoint of 3 years post catheterization. Percent change in BMI was calculated and its association with long-term all-cause mortality was investigated. Change in BMI of ±5% was observed in 46% of the patients, a decrease >5% in 15.5%, and an increase of >5% of BMI in 38.5%. Compared with those with the lowest change in BMI (±5%), the adjusted hazard ratios for mortality were 1.45 (95% confidence interval [CI], 1.27 to 1.65), and 1.69 (1.46 to 1.95) in patients with 5% to 10% and >10% decrease in BMI, respectively, and 1.05 (0.94 to 1.17), 1.15 (1.03 to 1.28), and 1.40 (1.19 to 1.64) in patients with 5% to 10%, 10% to 20% and >20% increase in BMI, respectively. The pattern was similar in normal-weight, overweight, and obese subgroups at baseline. However, the magnitude of the association with decrease BMI was more pronounced in normal-weight patients (P-for-interaction 0.031). In conclusion, the association of percent changes in BMI after cardiac catheterization and all-cause mortality had a reversed J-shaped pattern, with both weight loss and weight gain being associated with increased risk. A decrease in BMI was related to higher mortality rates than was an increase in BMI for a comparable degree of percent change.

Survival in patients on hemodialysis: Effect of gender according to body mass index and creatinine.

BackgroundThe association of a higher body mass index (BMI) with better survival is a well-known “obesity paradox” in patients on hemodialysis (HD). However, men and women have different body compositions, which could impact the effect of BMI on mortality. We investigated the effect of gender on the obesity-mortality relationship in Korean patients on HD.MethodsThis study included 2,833 maintenance patients on HD from a multicenter prospective cohort study in Korea (NCT00931970). The relationship between categorized BMI and gender-specific mortality was evaluated by an adjusted Cox proportional hazard model with restricted cubic spline analyses and the Competing risk analysis. We also investigated the effect of changes in BMI over 12 months and serum creatinine level on survival in male and female patients on HD.ResultsThe mean BMI was 22.6 ± 3.3 kg/m2 and the mean follow up duration was 24.2 ± 3.4 months. The patients with the highest quintile of BMI (≥25.1 kg/m2) showed lower mortality (subdistributional hazard ratio [SHR] = 0.63, 95% confidence interval [CI] = 0.43–0.93, P = 0.019) compared with those with the reference BMI quintile. When analyzed by gender, male patients with a BMI over 25.1 kg/m2 had lower mortality risk (HR = 0.43, 95% CI = 0.25–0.75, P = 0.003); however, no significant difference was found in female patients. Increased BMI after 12 months and high serum creatinine were associated with better survival only in male patients on HD.ConclusionsBMI could be used as a risk factor for mortality in male patients on HD. However, the mortality of female patients on HD was not related with baseline and follow-up BMI. This suggests that BMI is a good surrogate marker of lean body composition, especially in male patients on HD.

Body mass index change during adulthood and risk of oesophageal squamous-cell carcinoma in a Japanese population: the Japan Public Health (JPHC)-based prospective study

Background:The influence of body mass index (BMI) change during adulthood on the development of oesophageal squamous-cell carcinoma (ESCC) is unknown.Methods:Based on the Japan Public Health Center-based Prospective Study, we enrolled 103 238 participants from 1990 to 1994. Anthropometric data at age 20 years, baseline, and 5- and/or 10-year follow-up surveys were collected by questionnaire. The effect of BMI change between age 20 years and baseline on ESCC risk was estimated by Cox proportional hazards regression models. The updated BMI was taken into account by fitting a simple linear regression model for each individual, where the slope was incorporated into regressions as a time-varying variable.Results:After excluding the first 5 years of observation, we identified 342 newly diagnosed ESCC cases. An increase in BMI during adulthood was linked with a decreased risk of ESCC development, with each 1% increase per 5 years corresponding to a 15% decrease in ESCC risk (95% confidence interval 9–21%). Identical estimates were obtained from time-dependent models. The importance of BMI change was not modified by gender, smoking, or alcohol drinking but confined to participants assessed as non-overweight at baseline.Conclusions:An increase in BMI during adulthood is associated with a lower risk of developing ESCC among non-overweight subjects.

Effect of Changes in Body Mass Index on Cardiovascular Outcomes in Kidney Transplant Recipients

BackgroundA higher body mass index (BMI) before kidney transplantation (KT) is associated with increased mortality and allograft loss in kidney transplant recipients (KTRs). However, the effect of changes in BMI after KT on these outcomes remains uncertain. The aim of this study was to investigate the effect of baseline BMI and changes in BMI on clinical outcomes in KTRs. MethodsA total of 869 KTRs were enrolled from a multicenter observational cohort study from 2012 to 2015. Patients were divided into low and high BMI groups before KT based on a BMI cutoff point of 23 kg/m2. Differences in acute rejection and cardiovascular disease (CVD) between the 2 groups were analyzed. In addition, clinical outcomes across the 4 BMI groups divided by BMI change 1 year after KT were compared. Associations between BMI change and laboratory findings were also evaluated. ResultsPatients with a higher BMI before KT showed significantly increased CVD after KT (P = .027) compared with patients with a lower BMI. However, among the KTRs with a higher baseline BMI, only persistently higher BMI was associated with increased CVD during the follow-up period (P = .003). Patients with persistently higher BMI had significantly decreased high-density lipoprotein cholesterol and increased hemoglobin, triglyceride, and hemoglobin A1c levels. Baseline BMI and post-transplantation change in BMI were not related to acute rejection in KTRs. ConclusionsBMI in the 1st year after KT as well as baseline BMI were associated with CVD in KTRs. More careful monitoring of obese KTRs who do not undergo a reduction in BMI after KT is required.

Spirometry and Health Status Worsen with Weight Gain in Obese Smokers but Improve in Normal-Weight Smokers

The literature on the effect of obesity and weight gain on respiratory outcomes in smokers is contradictory. To examine the cross-sectional effect of body mass index (BMI) and the longitudinal effect of change in BMI upon spirometry and health status among smokers at risk for and with milder chronic obstructive pulmonary disease (COPD). Participants from the Lovelace Smokers' Cohort were followed for a median period of 6 years, 75% of whom were at risk and 25% of whom had COPD at baseline examination. BMI and gain in BMI were examined as continuous independent variables overall and after stratification into three categories (normal-weight, overweight, and obese) determined on the basis of baseline weight. Spirometry and health status (as assessed by St. George Respiratory Questionnaire total and subscale scores) were dependent variables. Covariates included age, sex, ethnicity, pack-years of smoking, and current smoking status. Cross-sectional analysis used linear and logistic regression; longitudinal analysis used a mixed model approach. In cross-sectional analyses, higher BMI was associated with worse health status among obese smokers but with better health status among normal-weight smokers. In longitudinal analyses, weight gain was associated with a decrease in FEV1 and health status among obese smokers and with an increase in these outcomes among normal-weight smokers. Weight gain affects respiratory outcomes differently between obese and normal-weight smokers. Whereas FEV1 and health status decrease with weight gain among obese smokers, they improve among normal-weight smokers. The nonlinear relationship between weight gain and respiratory outcomes suggests that this effect of excess weight is unlikely to be mechanical alone.

BMI Change, Fitness Change and Cardiometabolic Risk Factors Among 8th Grade Youth

This paper examined whether a two-year change in fitness, body mass index (BMI) or the additive effect of change in fitness and BMI were associated with change in cardiometabolic risk factors among youth. Cardiometabolic risk factors, BMI group (normal weight, overweight or obese) were obtained from participants at the start of 6th grade and end of 8th grade. Shuttle run laps were assessed and categorized in quintiles at both time points. Regression models were used to examine whether changes in obesity, fitness or the additive effect of change in BMI and fitness were associated with change in risk factors. There was strong evidence (p < .001) that change in BMI was associated with change in cardiometabolic risk factors. There was weaker evidence of a fitness effect, with some evidence that change in fitness was associated with change in total cholesterol, HDL-C, LDL-C and clustered risk score among boys, as well as HDL-C among girls. Male HDL-C was the only model for which there was some evidence of a BMI, fitness and additive BMI*fitness effect. Changing body mass is central to the reduction of youth cardiometabolic risk. Fitness effects were negligible once change in body mass had been taken into account.

BMI over the lifecourse and hearing ability at age 45 years: a population based study

Previous research on anthropometric factors and adult hearing loss has found relationships, in separate studies, to birthweight and contemporary BMI. However no study has examined data on BMI over the lifecourse. This paper uses data from the 1958 British Birth Cohort to examine relationships between BMI (both in childhood and adulthood), changes in BMI between adjacent age waves, and hearing thresholds at 1 kHz and 4 kHz obtained by audiometric examination at age 45 yrs. Body Mass Index (BMI) in adulthood, but not in childhood, was associated with increased hearing threshold levels at both 1 kHz and 4 kHz at age 45yrs. Two further models examine the effect of changes in BMI between successive waves and adult hearing thresholds, firstly adjusting for childhood hearing loss and a range of further childhood factors (including birthweight, family history of hearing loss, mother’s weight, childhood social class) and secondly adjusting in addition for noise, current social class, current systolic blood pressure and diabetes, current smoking and drinking. In the first model, increases in BMI at age intervals throughout the lifecourse, over both childhood and adulthood, were independently associated with increased hearing threshold levels at both frequencies in mid-life, largest relationships being shown at both frequencies to increasing BMI in adolescence and in early adulthood. These relationships generally persisted in the second model, though were reduced more at earlier ages (pre 23 yrs). Noise at work attenuates the relationship between BMI change and mid life hearing threshold, more so at 4 kHz than at 1 kHz and for BMI change at older ages.

Impact of a change of body mass index (BMI) on outcome following adjuvant endocrine therapy, chemotherapy, or trastuzumab for breast cancer.

513 Background: Pre-treatment BMI has been found to impact early breast cancer (EBC) outcomes and observational studies suggest that increasing BMI after diagnosis is detrimental. We hypothesize that changes in BMI after initial treatment of EBC are associated with breast cancer outcomes. Methods: We determined the effects of changes in BMI after initial treatment of EBC on disease outcomes in a series of NCIC CTG EBC clinical trials employing investigational therapies: chemotherapy (MA.5, MA.21), endocrine therapy (MA.12, MA.27), or biological therapy such as insulin-like growth factor pathway (MA.14) or trastuzumab therapy (MA24/HERA). Taking into account differing trial designs we created common operable definitions for investigative factors (BMI change at 1-, 3-, 5- years; age; ECOG performance status; menopausal status; race; T; nodal status; hormone receptor status; endocrine therapy; chemotherapy; anthracycline; trastuzumab) and STEEP endpoints. MA.14 and MA.27 results are provided here for breast cancer-free interval (BCFI), defined as the time from randomization until recurrence: first local invasive or DCIS; regional, or distant; contralateral invasive or DCIS; or death from breast cancer. Stratified Cox regression was used to assess the effect of continuous BMI changes on BCFI. Results: Preliminary results are as follows with a median FU of 9.8 years for MA14 and 4.1 years for MA27. There was no significant interaction between BMI changes and trial therapy (tamoxifen +/− octreotide LAR) in MA.14. Conclusions: In this analysis, increases in BMI at 1- and 5- years were associated with improved prognosis in MA14, with no difference based on treatment arm. BMI changes were not associated with BCFI in the MA.27 trial comparing aromatase inhibitors. At ASCO we will report results for all trials and endpoints. This data may impact our understanding of the role of BMI and breast cancer recurrence. Trial Year Number at risk Mean BMI % change BCFI (%) P value MA14 1 537 1.64 74.5 0.03 MA14 3 496 2.09 78.6 0.19 MA14 5 436 1.96 82.1 0.018 MA27 1 6,569 1.23 94.4 0.79 MA27 3 5,034 1.33 97.4 0.68 MA27 5 956 0.57 99.2 0.47

Pre-pregnancy body mass index change between pregnancies and preterm birth in the following pregnancy.

Maternal pre-pregnancy body mass index (BMI) may affect the risk of preterm birth. However, it is unclear how changes in BMI between pregnancies modify the risk of preterm birth in the following pregnancy. We studied this effect in the Collaborative Perinatal Project, when obesity was uncommon and the prevalence of induction of labour was low. This analysis included 1892 primiparae whose first enrolled (index) pregnancy was a singleton livebirth and the second enrolled (outcome) pregnancy was a consecutive singleton pregnancy (both pregnancies within 20-51 weeks of gestation). We used the Cox regression model to calculate the hazard ratio (HR) of preterm birth at the outcome pregnancy as a function of reduced BMI (<25(th) percentile of change) and increased BMI (>75(th) percentile), compared with stable BMI (25(th)-75(th) percentile), adjusted for pre-pregnancy BMI at the index pregnancy and other covariates. Body mass index reduction was associated with a non-significant increased risk of preterm birth, adjusted HR 1.17 [95% confidence interval 0.90, 1.53]; BMI increase had effects close to null (adjusted HR 1.08 [0.83, 1.41]). In the model with linear BMI change, each 1 kg/m(2) increase was associated with an HR of 0.96 [0.89, 1.03]. The estimates associated with a BMI reduction were higher in women whose index pregnancy ended preterm (HR 1.49 [0.90, 2.44]) and in those with BMI < 25 kg/m(2) at the index pregnancy (HR 1.30 [0.98, 1.71]). This study involved mainly low-to-normal weight women with spontaneous deliveries, and might suffer from type II error owing to small sample size. The effect of BMI change in overweight and obese women needs to be studied using contemporary data.

Change in body mass index and its impact on blood pressure: a prospective population study

Overweight and obesity increase the risk of elevated blood pressure, but the knowledge of the effect of weight change on blood pressure is sparse. To investigate the association between change in body mass index (BMI) and change in diastolic blood pressure (DBP), systolic blood pressure (SBP), and hypertension status. Two population-based cross-sectional studies, one in 1984-86 and the other in 1995-97. The Nord-Trondelag Health Study (HUNT). We included 15,971 women and 13,846 men who were 20 y or older at the first survey, without blood pressure medication at both surveys and without diabetes, cardiovascular disease or dysfunction in daily life at baseline. Weight, height and blood pressure were measured standardised. Change in BMI was categorised as stable (initial BMI+/-0.1 kg/m2 each follow-up year), increased or decreased, and BMI was categorised by using World Health Organisation's categorisation (underweight BMI: <18.5 kg/m2, normal weight BMI: 18.5-24.9 kg/m2, overweight BMI: 25.0-29.9 kg/m2, obesity BMI> or =30 kg/m2). An increase in BMI and a decrease in BMI were significantly associated with increased and decreased SBP and DBP, respectively, compared to a stable BMI in both genders and all age groups, although the strongest effect was found among those who were 50 y and older. The adjusted odds ratio for having hypertension at HUNT 2 was 1.8 (95% confidence interval (CI): 1.5, 2.2) among women and 1.6 (95% CI: 1.4,1.8) among men aged 20-49 y who increased their BMI compared to those who had stable BMI. A similar, but weaker association was found among women and men aged 50 y or more. The mean change in both SBP and DBP was higher for those who changed BMI category from first to the second survey than for those who were in the same BMI class at both surveys. Our result supports an independent effect of change in BMI on change in SBP and DBP in both women and men, and that people who increase their BMI are at increased risk for hypertension.